Van Diest Medical Center

All Charges

Charge

Type

Setting

Price

PACLitaxel 6 mg/mL 50 ml MDV Sol [VDMC]

Facility

$171.72

Service Code	HCPCS J9267
Hospital Charge Code	13461467
Hospital Revenue Code	259
Min. Negotiated Rate	$120.20
Max. Negotiated Rate	$154.55
Rate for Payer: Aetna of IA Commercial	$154.55
Rate for Payer: Aetna of IA Medical Rental Products	$154.55
Rate for Payer: Cash Price	$137.38
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$128.79
Rate for Payer: Medical Associates Commercial	$128.79
Rate for Payer: Midlands Choice Commercial	$120.20
Rate for Payer: United Healthcare Commercial	$154.55

PACLitaxel 6 mg/mL 5 ml MDV Vial [VDMC]

Facility

$77.96

Service Code	HCPCS J9267
Hospital Charge Code	13461331
Hospital Revenue Code	259
Min. Negotiated Rate	$54.57
Max. Negotiated Rate	$70.16
Rate for Payer: Aetna of IA Commercial	$70.16
Rate for Payer: Aetna of IA Medical Rental Products	$70.16
Rate for Payer: Cash Price	$62.37
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$58.47
Rate for Payer: Medical Associates Commercial	$58.47
Rate for Payer: Midlands Choice Commercial	$54.57
Rate for Payer: United Healthcare Commercial	$70.16

PACLitaxel 6 mg/mL 5 ml MDV Vial [VDMC]

Facility

$77.96

Service Code	HCPCS J9267
Hospital Charge Code	13461331
Hospital Revenue Code	259
Min. Negotiated Rate	$38.96
Max. Negotiated Rate	$70.16
Rate for Payer: Aetna of IA Commercial	$70.16
Rate for Payer: Aetna of IA Medical Rental Products	$70.16
Rate for Payer: Aetna of IA Medicare	$44.44
Rate for Payer: Amerigroup Medicaid	$39.35
Rate for Payer: Amerigroup Medicare	$39.37
Rate for Payer: Cash Price	$62.37
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$58.47
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$38.98
Rate for Payer: Iowa Total Care Managed Medicaid	$38.96
Rate for Payer: Medical Associates Commercial	$58.47
Rate for Payer: Medical Associates Managed Medicare	$38.98
Rate for Payer: Midlands Choice Commercial	$54.57
Rate for Payer: Molina Healthcare Managed Medicaid	$39.56
Rate for Payer: Molina Healthcare Managed Medicare	$39.54
Rate for Payer: Oscar Health of IA Commercial	$58.47
Rate for Payer: Partners Health Alliance Commercial	$58.47
Rate for Payer: United Healthcare Commercial	$70.16
Rate for Payer: United Healthcare Managed Medicare	$46.00

PACLitaxel protein-bound 100 mg SDV [VDMC]

Facility

$5,916.64

Service Code	HCPCS J9264
Hospital Charge Code	21401025
Hospital Revenue Code	259
Min. Negotiated Rate	$2,957.14
Max. Negotiated Rate	$5,324.98
Rate for Payer: Aetna of IA Commercial	$5,324.98
Rate for Payer: Aetna of IA Medical Rental Products	$5,324.98
Rate for Payer: Aetna of IA Medicare	$3,372.48
Rate for Payer: Amerigroup Medicaid	$2,986.13
Rate for Payer: Amerigroup Medicare	$2,987.90
Rate for Payer: Cash Price	$4,733.31
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$4,437.48
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$2,958.32
Rate for Payer: Iowa Total Care Managed Medicaid	$2,957.14
Rate for Payer: Medical Associates Commercial	$4,437.48
Rate for Payer: Medical Associates Managed Medicare	$2,958.32
Rate for Payer: Midlands Choice Commercial	$4,141.65
Rate for Payer: Molina Healthcare Managed Medicaid	$3,002.69
Rate for Payer: Molina Healthcare Managed Medicare	$3,000.92
Rate for Payer: Oscar Health of IA Commercial	$4,437.48
Rate for Payer: Partners Health Alliance Commercial	$4,437.48
Rate for Payer: United Healthcare Commercial	$5,324.98
Rate for Payer: United Healthcare Managed Medicare	$3,490.82

PACLitaxel protein-bound 100 mg SDV [VDMC]

Facility

$5,916.64

Service Code	HCPCS J9264
Hospital Charge Code	21401025
Hospital Revenue Code	259
Min. Negotiated Rate	$4,141.65
Max. Negotiated Rate	$5,324.98
Rate for Payer: Aetna of IA Commercial	$5,324.98
Rate for Payer: Aetna of IA Medical Rental Products	$5,324.98
Rate for Payer: Cash Price	$4,733.31
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$4,437.48
Rate for Payer: Medical Associates Commercial	$4,437.48
Rate for Payer: Midlands Choice Commercial	$4,141.65
Rate for Payer: United Healthcare Commercial	$5,324.98

Pain Clinic Survey Urine DMCL

Facility

$94.00

Service Code	CPT 80364
Hospital Charge Code	8539461
Hospital Revenue Code	301
Min. Negotiated Rate	$65.80
Max. Negotiated Rate	$84.60
Rate for Payer: Aetna of IA Commercial	$84.60
Rate for Payer: Aetna of IA Medical Rental Products	$84.60
Rate for Payer: Cash Price	$75.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$70.50
Rate for Payer: Medical Associates Commercial	$70.50
Rate for Payer: Midlands Choice Commercial	$65.80
Rate for Payer: United Healthcare Commercial	$84.60

Pain Clinic Survey Urine DMCL

Facility

$94.00

Service Code	CPT 80364
Hospital Charge Code	8539461
Hospital Revenue Code	301
Min. Negotiated Rate	$20.46
Max. Negotiated Rate	$84.60
Rate for Payer: Aetna of IA Commercial	$84.60
Rate for Payer: Aetna of IA Medical Rental Products	$84.60
Rate for Payer: Aetna of IA Medicare	$53.58
Rate for Payer: Amerigroup Medicaid	$47.44
Rate for Payer: Amerigroup Medicare	$47.47
Rate for Payer: Cash Price	$75.20
Rate for Payer: Cash Price	$75.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$70.50
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$47.00
Rate for Payer: Iowa Total Care Managed Medicaid	$46.98
Rate for Payer: Medical Associates Commercial	$70.50
Rate for Payer: Medical Associates Managed Medicare	$47.00
Rate for Payer: Midlands Choice Commercial	$65.80
Rate for Payer: Molina Healthcare Managed Medicaid	$47.70
Rate for Payer: Molina Healthcare Managed Medicare	$47.68
Rate for Payer: Oscar Health of IA Commercial	$70.50
Rate for Payer: Partners Health Alliance Commercial	$70.50
Rate for Payer: United Healthcare Commercial	$84.60
Rate for Payer: United Healthcare Managed Medicare	$55.46
Rate for Payer: Wellmark IA HMO	$20.46
Rate for Payer: Wellmark IA PPO	$22.51

Pain Clinic Survey Urine DMCL

Facility

$139.00

Service Code	CPT 80307
Hospital Charge Code	8539276
Hospital Revenue Code	301
Min. Negotiated Rate	$69.47
Max. Negotiated Rate	$125.10
Rate for Payer: Aetna of IA Commercial	$125.10
Rate for Payer: Aetna of IA Medical Rental Products	$125.10
Rate for Payer: Aetna of IA Medicare	$79.23
Rate for Payer: Amerigroup Medicaid	$70.15
Rate for Payer: Amerigroup Medicare	$70.20
Rate for Payer: Cash Price	$111.20
Rate for Payer: Cash Price	$111.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$104.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$69.50
Rate for Payer: Iowa Total Care Managed Medicaid	$69.47
Rate for Payer: Medical Associates Commercial	$104.25
Rate for Payer: Medical Associates Managed Medicare	$69.50
Rate for Payer: Midlands Choice Commercial	$97.30
Rate for Payer: Molina Healthcare Managed Medicaid	$70.54
Rate for Payer: Molina Healthcare Managed Medicare	$70.50
Rate for Payer: Oscar Health of IA Commercial	$104.25
Rate for Payer: Partners Health Alliance Commercial	$104.25
Rate for Payer: United Healthcare Commercial	$125.10
Rate for Payer: United Healthcare Managed Medicare	$82.01
Rate for Payer: Wellmark IA HMO	$102.92
Rate for Payer: Wellmark IA PPO	$113.21

Pain Clinic Survey Urine DMCL

Facility

$139.00

Service Code	CPT 80307
Hospital Charge Code	8539276
Hospital Revenue Code	301
Min. Negotiated Rate	$97.30
Max. Negotiated Rate	$125.10
Rate for Payer: Aetna of IA Commercial	$125.10
Rate for Payer: Aetna of IA Medical Rental Products	$125.10
Rate for Payer: Cash Price	$111.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$104.25
Rate for Payer: Medical Associates Commercial	$104.25
Rate for Payer: Midlands Choice Commercial	$97.30
Rate for Payer: United Healthcare Commercial	$125.10

paliperidone palmitate 1560 mg/5 mL Sus [VDMC]

Facility

$37,769.90

Service Code	HCPCS J2427
Hospital Charge Code	26738572
Hospital Revenue Code	259
Min. Negotiated Rate	$26,438.93
Max. Negotiated Rate	$33,992.91
Rate for Payer: Aetna of IA Commercial	$33,992.91
Rate for Payer: Aetna of IA Medical Rental Products	$33,992.91
Rate for Payer: Cash Price	$30,215.92
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$28,327.42
Rate for Payer: Medical Associates Commercial	$28,327.42
Rate for Payer: Midlands Choice Commercial	$26,438.93
Rate for Payer: United Healthcare Commercial	$33,992.91

paliperidone palmitate 1560 mg/5 mL Sus [VDMC]

Facility

$37,769.90

Service Code	HCPCS J2427
Hospital Charge Code	26738572
Hospital Revenue Code	259
Min. Negotiated Rate	$18,877.40
Max. Negotiated Rate	$33,992.91
Rate for Payer: Aetna of IA Commercial	$33,992.91
Rate for Payer: Aetna of IA Medical Rental Products	$33,992.91
Rate for Payer: Aetna of IA Medicare	$21,528.84
Rate for Payer: Amerigroup Medicaid	$19,062.47
Rate for Payer: Amerigroup Medicare	$19,073.80
Rate for Payer: Cash Price	$30,215.92
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$28,327.42
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$18,884.95
Rate for Payer: Iowa Total Care Managed Medicaid	$18,877.40
Rate for Payer: Medical Associates Commercial	$28,327.42
Rate for Payer: Medical Associates Managed Medicare	$18,884.95
Rate for Payer: Midlands Choice Commercial	$26,438.93
Rate for Payer: Molina Healthcare Managed Medicaid	$19,168.22
Rate for Payer: Molina Healthcare Managed Medicare	$19,156.89
Rate for Payer: Oscar Health of IA Commercial	$28,327.42
Rate for Payer: Partners Health Alliance Commercial	$28,327.42
Rate for Payer: United Healthcare Commercial	$33,992.91
Rate for Payer: United Healthcare Managed Medicare	$22,284.24

palonosetron 0.25 mg/5 mL SDV [VDMC]

Facility

$203.96

Service Code	HCPCS J2469
Hospital Charge Code	13339269
Hospital Revenue Code	259
Min. Negotiated Rate	$142.77
Max. Negotiated Rate	$183.56
Rate for Payer: Aetna of IA Commercial	$183.56
Rate for Payer: Aetna of IA Medical Rental Products	$183.56
Rate for Payer: Cash Price	$163.17
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$152.97
Rate for Payer: Medical Associates Commercial	$152.97
Rate for Payer: Midlands Choice Commercial	$142.77
Rate for Payer: United Healthcare Commercial	$183.56

palonosetron 0.25 mg/5 mL SDV [VDMC]

Facility

$203.96

Service Code	HCPCS J2469
Hospital Charge Code	13339269
Hospital Revenue Code	259
Min. Negotiated Rate	$101.94
Max. Negotiated Rate	$183.56
Rate for Payer: Aetna of IA Commercial	$183.56
Rate for Payer: Aetna of IA Medical Rental Products	$183.56
Rate for Payer: Aetna of IA Medicare	$116.26
Rate for Payer: Amerigroup Medicaid	$102.94
Rate for Payer: Amerigroup Medicare	$103.00
Rate for Payer: Cash Price	$163.17
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$152.97
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$101.98
Rate for Payer: Iowa Total Care Managed Medicaid	$101.94
Rate for Payer: Medical Associates Commercial	$152.97
Rate for Payer: Medical Associates Managed Medicare	$101.98
Rate for Payer: Midlands Choice Commercial	$142.77
Rate for Payer: Molina Healthcare Managed Medicaid	$103.51
Rate for Payer: Molina Healthcare Managed Medicare	$103.45
Rate for Payer: Oscar Health of IA Commercial	$152.97
Rate for Payer: Partners Health Alliance Commercial	$152.97
Rate for Payer: United Healthcare Commercial	$183.56
Rate for Payer: United Healthcare Managed Medicare	$120.34

pamidronate 3 mg/mL 10 ml SDV [VDMC]

Facility

$54.24

Service Code	HCPCS J2430
Hospital Charge Code	10411386
Hospital Revenue Code	259
Min. Negotiated Rate	$37.97
Max. Negotiated Rate	$48.82
Rate for Payer: Aetna of IA Commercial	$48.82
Rate for Payer: Aetna of IA Medical Rental Products	$48.82
Rate for Payer: Cash Price	$43.39
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$40.68
Rate for Payer: Medical Associates Commercial	$40.68
Rate for Payer: Midlands Choice Commercial	$37.97
Rate for Payer: United Healthcare Commercial	$48.82

pamidronate 3 mg/mL 10 ml SDV [VDMC]

Facility

$54.24

Service Code	HCPCS J2430
Hospital Charge Code	10411386
Hospital Revenue Code	259
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$48.82
Rate for Payer: Aetna of IA Commercial	$48.82
Rate for Payer: Aetna of IA Medical Rental Products	$48.82
Rate for Payer: Aetna of IA Medicare	$30.92
Rate for Payer: Amerigroup Medicaid	$27.37
Rate for Payer: Amerigroup Medicare	$27.39
Rate for Payer: Cash Price	$43.39
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$40.68
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$27.12
Rate for Payer: Iowa Total Care Managed Medicaid	$27.11
Rate for Payer: Medical Associates Commercial	$40.68
Rate for Payer: Medical Associates Managed Medicare	$27.12
Rate for Payer: Midlands Choice Commercial	$37.97
Rate for Payer: Molina Healthcare Managed Medicaid	$27.53
Rate for Payer: Molina Healthcare Managed Medicare	$27.51
Rate for Payer: Oscar Health of IA Commercial	$40.68
Rate for Payer: Partners Health Alliance Commercial	$40.68
Rate for Payer: United Healthcare Commercial	$48.82
Rate for Payer: United Healthcare Managed Medicare	$32.00

Pancreas, Liver and Shunt Procedures With CC

Facility

$24,443.64

Service Code	MS-DRG 406
Hospital Charge Code	238
Min. Negotiated Rate	$24,089.38
Max. Negotiated Rate	$24,443.64
Rate for Payer: Amerigroup Medicaid	$24,325.55
Rate for Payer: Iowa Total Care Managed Medicaid	$24,089.38
Rate for Payer: Molina Healthcare Managed Medicaid	$24,443.64

Pancreas, Liver and Shunt Procedures With MCC

Facility

$40,277.13

Service Code	MS-DRG 405
Hospital Charge Code	237
Min. Negotiated Rate	$39,693.40
Max. Negotiated Rate	$40,277.13
Rate for Payer: Amerigroup Medicaid	$40,082.55
Rate for Payer: Iowa Total Care Managed Medicaid	$39,693.40
Rate for Payer: Molina Healthcare Managed Medicaid	$40,277.13

Pancreas, Liver and Shunt Procedures Without CC/MCC

Facility

$17,272.45

Service Code	MS-DRG 407
Hospital Charge Code	239
Min. Negotiated Rate	$17,022.13
Max. Negotiated Rate	$17,272.45
Rate for Payer: Amerigroup Medicaid	$17,189.01
Rate for Payer: Iowa Total Care Managed Medicaid	$17,022.13
Rate for Payer: Molina Healthcare Managed Medicaid	$17,272.45

Pancreas Transplant

Facility

$35,615.77

Service Code	MS-DRG 010
Hospital Charge Code	700
Min. Negotiated Rate	$35,099.60
Max. Negotiated Rate	$35,615.77
Rate for Payer: Amerigroup Medicaid	$35,443.71
Rate for Payer: Iowa Total Care Managed Medicaid	$35,099.60
Rate for Payer: Molina Healthcare Managed Medicaid	$35,615.77

pantoprazole 20 mg Oral DR Tab [VDMC]

Facility

$1.13

Service Code	HCPCS A9270
Hospital Charge Code	10411658
Hospital Revenue Code	259
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$1.02
Rate for Payer: Aetna of IA Commercial	$1.02
Rate for Payer: Aetna of IA Medical Rental Products	$1.02
Rate for Payer: Cash Price	$0.90
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$0.85
Rate for Payer: Medical Associates Commercial	$0.85
Rate for Payer: Midlands Choice Commercial	$0.79
Rate for Payer: United Healthcare Commercial	$1.02

pantoprazole 20 mg Oral DR Tab [VDMC]

Facility

$1.13

Service Code	HCPCS A9270
Hospital Charge Code	10411658
Hospital Revenue Code	259
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$1.02
Rate for Payer: Aetna of IA Commercial	$1.02
Rate for Payer: Aetna of IA Medical Rental Products	$1.02
Rate for Payer: Aetna of IA Medicare	$0.64
Rate for Payer: Amerigroup Medicaid	$0.57
Rate for Payer: Amerigroup Medicare	$0.57
Rate for Payer: Cash Price	$0.90
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$0.85
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$0.57
Rate for Payer: Iowa Total Care Managed Medicaid	$0.56
Rate for Payer: Medical Associates Commercial	$0.85
Rate for Payer: Medical Associates Managed Medicare	$0.57
Rate for Payer: Midlands Choice Commercial	$0.79
Rate for Payer: Molina Healthcare Managed Medicaid	$0.57
Rate for Payer: Molina Healthcare Managed Medicare	$0.57
Rate for Payer: Oscar Health of IA Commercial	$0.85
Rate for Payer: Partners Health Alliance Commercial	$0.85
Rate for Payer: United Healthcare Commercial	$1.02
Rate for Payer: United Healthcare Managed Medicare	$0.67

pantoprazole 40 mg IV Inj [VDMC]

Facility

$28.88

Service Code	HCPCS J3490
Hospital Charge Code	10411727
Hospital Revenue Code	259
Min. Negotiated Rate	$14.43
Max. Negotiated Rate	$25.99
Rate for Payer: Aetna of IA Commercial	$25.99
Rate for Payer: Aetna of IA Medical Rental Products	$25.99
Rate for Payer: Aetna of IA Medicare	$16.46
Rate for Payer: Amerigroup Medicaid	$14.58
Rate for Payer: Amerigroup Medicare	$14.58
Rate for Payer: Cash Price	$23.10
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$21.66
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$14.44
Rate for Payer: Iowa Total Care Managed Medicaid	$14.43
Rate for Payer: Medical Associates Commercial	$21.66
Rate for Payer: Medical Associates Managed Medicare	$14.44
Rate for Payer: Midlands Choice Commercial	$20.22
Rate for Payer: Molina Healthcare Managed Medicaid	$14.66
Rate for Payer: Molina Healthcare Managed Medicare	$14.65
Rate for Payer: Oscar Health of IA Commercial	$21.66
Rate for Payer: Partners Health Alliance Commercial	$21.66
Rate for Payer: United Healthcare Commercial	$25.99
Rate for Payer: United Healthcare Managed Medicare	$17.04

pantoprazole 40 mg IV Inj [VDMC]

Facility

$28.88

Service Code	HCPCS J3490
Hospital Charge Code	10411727
Hospital Revenue Code	259
Min. Negotiated Rate	$20.22
Max. Negotiated Rate	$25.99
Rate for Payer: Aetna of IA Commercial	$25.99
Rate for Payer: Aetna of IA Medical Rental Products	$25.99
Rate for Payer: Cash Price	$23.10
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$21.66
Rate for Payer: Medical Associates Commercial	$21.66
Rate for Payer: Midlands Choice Commercial	$20.22
Rate for Payer: United Healthcare Commercial	$25.99

pantoprazole 40 mg Oral DR Tab [VDMC]

Facility

$1.42

Service Code	HCPCS A9270
Hospital Charge Code	10411794
Hospital Revenue Code	259
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$1.28
Rate for Payer: Aetna of IA Commercial	$1.28
Rate for Payer: Aetna of IA Medical Rental Products	$1.28
Rate for Payer: Cash Price	$1.14
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$1.06
Rate for Payer: Medical Associates Commercial	$1.06
Rate for Payer: Midlands Choice Commercial	$0.99
Rate for Payer: United Healthcare Commercial	$1.28

pantoprazole 40 mg Oral DR Tab [VDMC]

Facility

$1.42

Service Code	HCPCS A9270
Hospital Charge Code	10411794
Hospital Revenue Code	259
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$1.28
Rate for Payer: Aetna of IA Commercial	$1.28
Rate for Payer: Aetna of IA Medical Rental Products	$1.28
Rate for Payer: Aetna of IA Medicare	$0.81
Rate for Payer: Amerigroup Medicaid	$0.72
Rate for Payer: Amerigroup Medicare	$0.72
Rate for Payer: Cash Price	$1.14
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$1.06
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$0.71
Rate for Payer: Iowa Total Care Managed Medicaid	$0.71
Rate for Payer: Medical Associates Commercial	$1.06
Rate for Payer: Medical Associates Managed Medicare	$0.71
Rate for Payer: Midlands Choice Commercial	$0.99
Rate for Payer: Molina Healthcare Managed Medicaid	$0.72
Rate for Payer: Molina Healthcare Managed Medicare	$0.72
Rate for Payer: Oscar Health of IA Commercial	$1.06
Rate for Payer: Partners Health Alliance Commercial	$1.06
Rate for Payer: United Healthcare Commercial	$1.28
Rate for Payer: United Healthcare Managed Medicare	$0.84

Know your out-of-pocket cost for care.

All Charges